Healthcare Provider Details

I. General information

NPI: 1508251182
Provider Name (Legal Business Name): AMY LIAO ASKEW MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 04/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 LAKE BOONE TRL STE 315
RALEIGH NC
27607-7510
US

IV. Provider business mailing address

4325 LAKE BOONE TRL STE 315
RALEIGH NC
27607-7510
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-0496
  • Fax:
Mailing address:
  • Phone: 984-974-0496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2019-00832
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: